BMC anesthesiology
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Observational Study
Anesthesia depth monitoring during opioid free anesthesia - a prospective observational study.
Patients undergoing general anesthesia are more frequently monitored for depth of anesthesia using processed electroencephalography. Opioid-free anesthesia is nowadays an accepted modality for general anesthesia, however it is unclear how to interpret data from processed electroencephalography when using a mixture of non-opioid anesthetic drugs. Our objective was to describe density spectral array patterns and compare processed encephalographic data indices between opioid-free and routine opioid based anesthesia. ⋯ Processed electroencephalography monitoring can be used in opioid-free anesthesia, however clinicians should expect higher values in monitoring indices. The density spectral array pattern using a common protocol for opioid-free anesthesia, with mainly sevoflurane combined with low doses of dexmedetomidine and esketamine, differs from well described opioid and GABA-ergic anesthesia methods. These findings should be further validated using other protocols for opioid-free anesthesia in order to safely monitor anesthesia depth.
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Randomized Controlled Trial
The effect of preoperative deep breathing exercise with incentive spirometer initiated in the preoperative period on respiratory parameters and complications in patients underwent open heart surgery: a randomized controlled trial.
Incentive spirometer is used in lung expansion therapy to maintain alveolar patency and improve pulmonary volumes in postoperative cardiac surgical patients. Deep breathing exercises with an incentive spirometer significantly reduce the development of postoperative pulmonary complications after open-heart cardiac surgery. ⋯ Deep breathing exercises with an incentive spirometer initiated in the preoperative period contribute to a reduction in postoperative pulmonary complication rates, shortening of mechanical ventilation time, length of stay in the intensive care unit, length of hospital stay, and improvement of pre- and postoperative oxygenation.
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We systematically reviewed the evidence on the effect of anesthetic methods and drugs on the incidence of postoperative cognitive dysfunction (POCD) after cataract surgery. ⋯ This systematic review investigates how different anesthetic techniques and drugs may affect the incidence of POCD. The available literature is far from being conclusive and further studies are needed to reach any significant conclusions. It is necessary to adopt an appropriate anesthesia method for elderly and high-risk patients, especially people who have a history of cognitive problems undergoing elective cataract surgery, to reduce cognitive complications after surgery..
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Randomized Controlled Trial
Effect of different doses of ciprofol on hemodynamics induced by general anesthesia in elderly diabetic patients undergoing spinal surgery: a double-blind, randomized, controlled study.
To evaluate the safety and efficacy of different doses of ciprofol for the induction of general anesthesia in elderly patients with diabetes undergoing spinal surgery. ⋯ The incidence of hypotension in Group C (46.4%) was significantly higher than that in Groups A (7.4%) and B (14.8%) (P < 0.05). The area under the time-mean arterial pressure curve (AUTMAP) was significantly greater in Group C (176.39 ± 33.83 mmHg·min) than in Group B (158.44 ± 26.55 mmHg·min) and Group A (143.59 ± 19.52 mmHg·min) (P < 0.05). The incidence of intubation response was highest in Group A (77.8%, P < 0.05). Significant differences in bispectral index (BIS) values were observed at 3, 4, and 5 min post-administration among the groups CONCLUSIONS: The induction regimen of 0.3 mg/kg ciprofol combined with 0.4 µg/kg sufentanil and 0.7 mg/kg rocuronium provided superior hemodynamic stability and reduced the need for vasoactive drugs in elderly diabetic patients. This regimen was found to be more favorable compared to the 0.2 mg/kg and 0.4 mg/kg ciprofol dosing groups, demonstrating an optimal balance of safety and efficacy during anesthesia induction in this high-risk population. This trial was registered in the Chinese Clinical Trial Registry on February 26, 2024 (Registration Number: ChiCTR2400081164).
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Observational Study
Anesthesia for pregnant patients with symptomatic neurological disease: 13 years' experience from a tertiary care center.
Improvements in diagnostics and clinical care have allowed more women of childbearing age, suffering from neurological diseases, to safely have pregnancy, reducing peripartum complications. However, these patients remain at risk and are a constant challenge for anesthesiologists in the delivery room. ⋯ In our experience, when neuraxial anesthesia was feasible, it proved to be a safe option for pregnant patients with symptomatic neurological disease, resulting in uncommon maternal complications.